POWERCHART NAME

AFB CULTURE OTHER

MERCY TEST NAME

ACID FAST CLT/SMR*

MERCY LAB CODE

AFBCLT

Comment: 

Specify collection site on requisition.

Specimen: 

Submit each specimen in a sterile container with a tight fitting lid.

• Body fluids:  Minimum of 5 ml specimen.
• Bronchus washings/brushings:  Minimum of 5 ml bronchus washings/brushings.
• Cerebrospinal fluid:  1 ml CSF minimum in a sterile plastic screw cap tube.
• Gastric washings:  1 ml specimen minimum.
• Sputum:  Minimum of 5 ml specimen.  A first morning specimen is recommended.
• Stool:  Submit a pea size sample.  No preservative.
• Tissue:  Submit a pea size sample. Can be placed in a small amount of saline to prevent drying out.
• Urine:  Minimum of 50 ml of urine. The first morning specimen is recommended. 
• Bone Marrow: Send using lithium heparin tubes.

Cause for rejection:

Serum is submitted for testing.

Processing:

• Send to the laboratory immediately after collection.
• Specimens are referred to Mayo Medical Laboratories, Rochester, MN for an AFB smear and culture.

Performed:

Smear:  Monday through Sunday. Mayo will contact Mercy Lab if positive.
Final:  8 weeks. Mayo will notify Mercy Lab if culture is positive prior to 8 weeks.

If tissue is submitted for testing, an additional charge will be assessed for processing.

If a bacteremia due to mycobacterium is suspected, see BLOOD CULTURE/ACID FAST ORGANISMS

Reference values:

AFB smear: No acid fast organisms seen.
                 If the smear is positive: Mycobacterium tuberculosis, Amplified Direct
                                                        Test is available at an additional charge.
AFB culture: No acid fast organisms isolated.
                  If the culture is positive for Mycobacterium: Antimicrobial
                             Susceptibility testing is available at an additional charge.
                             This testing has to be requested by the ordering location or
                             provider.

Method:

AFB smear: Auramine-Rhodamine Stain
AFB culture: Automated Detection plus 7H10-11 agar
Identification of AFB isolates by rapid methods: Nucleic Acid Probes, DNA Sequencing
                                                                    and Real-Time PCR, when appropriate.

CPT Code:

87206- Smear

87116- Culture, Mycobacterium

87149- Identification of Mycobacteria by nucleic acid probe (if appropriate)

87158- Identification of Mycobacteria by other methods (if appropriate)

87176- Tissue Processing (if appropriate)

TEST NAME

AEROBIC CULTURE /GRAM STAIN

See:Cultures are listed according to collection site. Order according to the source of the specimen.If there is no culture for the specific source, then order according to the type of culture i.e. body fluid, wound, etc.

POWERCHART NAME

ANAEROBIC CULTURE + SMEAR

MERCY TEST NAME

ANAEROBIC CLT/GS

MERCY LAB CODE

ANER

DO NOT USE AEROBIC TRANSPORTER!
A Port-A-Cul Cary Blair tube or Port-A-Cul anaerobic transport vial should be used. Both transport systems contain an indicator which will turn purple when oxygen is present.
DO NOT USE the transporter if the indicator is purple prior to opening the transporter.

Swab specimens:> Embed swab deeply into Port-A-Cul Cary Blair tube and cap tightly. Two swabs from the same specimen site should be submitted in one transport tube.

Fluid or pus aspirates:Inject specimen into Port-A-Cul vials. DO NOT inject air into vial.

Listing of acceptable and unacceptable specimens:

ACCEPTABLE specimens for anaerobic culture

1. Exudates or aspirated pus from deep wounds/abscesses
2. Surgical specimens
3. Normally sterile body fluids
4. Transtracheal aspirates
5. Suprapubic urines from:
   1. Percutaneous bladder aspiration
   2. Nephrostomy tubes
   3. Suprapubic catheter
6. Genital specimens ONLY as follows:
   1. Cul de sac aspiration
   2. Culdocentesis

UNACCEPTABLE specimens for anaerobic culture:

1. Superficial wounds
2. Specimens contaminated with intestinal flora ‑such as intestinal contents, colostomy sites, drainage from a pilonidal sinus, or bowel perforations.
3. Feces/rectal swabs
4. Throat/nasopharyngeal swabs
5. Sputum/bronchoscopic specimens
6. Vaginal/cervical swabs
7. Midstream or catheterized urine specimens

1. Specimens will be processed according to site.Only predominant anaerobes will be reported from cultures contaminated with oral, genital, or intestinal flora.
2. Identification to genus and species will only be performed on isolates from blood, CSF and other normally sterile body fluids.
3. Anaerobic susceptibility testing will not routinely be performed.Anaerobic susceptibility testing may be referred to Mayo Medical Laboratories, Rochester, MN. Contact Mercy Microbiology Lab (x7494) for information.

Gram stain: Next day 1st shift, unless ordered to be called stat with the specific phone number indicated.
Preliminary report: 2 - 4 days
Final report: 7 days

87205 Gram Stain+
87075 Anaerobic Clt+

TEST NAME

BACTERIAL ANTIGENS CSF NEONATAL (< 1 week of age)

TEST NAME

BACTERIAL ANTIGENS CSF PEDIATRIC (1 week to 17 years)

TEST NAME

BACTERIAL ANTIGENS CSF (18 years and older)

TEST NAME

BACTERIAL ANTIGENS URINE (< 1 week of age)

TEST NAME

BACTERIAL ANTIGENS URINE (1 week to 17 years)

TEST NAME

BACTERIAL ANTIGENS URINE (18 years and older)

POWERCHART NAME

BACTERIAL ANTIGENS PANEL CSF

MERCY TEST NAME

MERCY LAB CODE

BACTAG

1. Orderable if desired by physician. Recommended for persons > 1 week old.
2. Antigens tested: Haemophilus influenzae type B Neisseria meningitidis group B/E, coli K1, Neisseria meningitides groups A, C, Y, and W135, and Streptococcus pneumoniae. Includes Stroptococcus agalacitae (group B) on infants < 3 months old.
3. Positive bacterial antigens results are called to the doctor or nursing unit.
4. Antigens are not intended to replace bacterial culture. Please order Fluid Culture also.

Same day, Monday - Sunday. Sent to Mayo. Mayo # 80366

POWERCHART NAME

STREP GROUP B ANTIGEN CSF NEONATAL ORDER (<1 week of age)

MERCY TEST NAME

MERCY LAB CODE

GBSAG

1. Recommended for infants less than 1 week of age.
2. Antigens tested: Stroptococcus agalacitae (group B)
3. Positive bacterial antigens results are called to the doctor or nursing unit.
4. Antigens are not intended to replace bacterial culture. Please order Fluid Culture also.

Within 8 hours of receipt

POWERCHART NAME

CULTURE IDENTIFICATION BACTERIAL

MERCY TEST NAME

BACTERIAL ID RL

MERCY LAB CODE

MCID

1 Organism per request.
Mark OTHER under Microbiology Cultures on the order form & write Bacterial Identification.Write collection site on SOURCE line.
You must also complete a Reference Bacteria Examination Form for each organism.Indicate on reference bacteria form if susceptibility testing is desired.Send both forms.A copy of the Reference Bacteria Form is located in the Special Helps Section.

POWERCHART NAME

BLOOD CULTURE

MERCY TEST NAME

BLOOD CLT

MERCY LAB CODE

BLC

Mark Blood Culture on order form.Write collection site on SOURCE line.

If yeast or fungus is suspected, see Blood Culture for Fungus for ordering and collection information.

If mycobacteremia (AFB,TB) is suspected, see Acid Fast Culture/smear for ordering and collection information.

Specimens must be collected using sterile techniques.

1. Cleanse site with 70% isopropyl alcohol, followed by a 2 minute scrub with 2% tinctures of iodine solution.
2. Remove & discard the plastic cover(s) from the culture bottle.
3. Disinfect the rubber septum of each bottle with a 70% alcohol pad or iodine.
4. Do not touch venipuncture site.Use a syringe or BacTALERT Blood Collection Adapter Set to obtain the blood cultures. Draw 1-4 ml for pediatric patients <5 yrs old. Draw 20 ml for all others.
5. For syringe draws only: Place a new needle on the syringe.Put blood into blood culture bottles, using the following procedure:
   
   Pediatric (<5yrs):
   Inject 1-4 ml whole blood into the BacTALERTPediatric PF bottle (yellow).Avoid injecting air into the bottle. Invert to mix.
   
   Patients > 5 yrs old: Draw 20 ml blood.
   Inject 10 ml blood into the aerobic bottle (green) and 10 ml of whole blood into the anaerobic bottle (purple)
   Avoid injecting air into the bottles. Invert to mix.
6. If the BacTALERT Blood Collection Adapter Set is used, draw 4ml of blood into the Pediatric PF bottle (yellow) OR 10ml of blood into each aerobic (green) and anaerobic (purple) bottle.

1. Three sets of blood cultures within a 24‑hour period is recommended.
2. Culture is tested daily by continuous monitoring technology.
3. Culture detects both aerobic and anaerobic bacteria.
4. The aerobic and pediatric bottles used for older pediatric patients and adults contain a resin which will aid in the recovery of organisms if antimicrobial therapy was initiated before the culture was obtained.
5. ALL POSITIVE BLOOD CULTURE RESULTS WILL BE PHONED TO THE PHYSICIAN OR NURSING PERSONNEL RESPONSIBLE FOR THE PATIENT.
6. Susceptibility testing routinely will be performed on aerobic isolates. (With the exception of diphtheroids, Bacillus species, Viridans Streptococcus.)

Preliminary report: Daily
Final report: 5 days

TEST NAME

BLOOD CULTURE/ACID FAST ORGANISMS

MERCY TEST NAME

MISC MICROBIOLOGY

MERCY LAB CODE

MISM

AFB smear by fluorochrome staining
AFB culture by liquid radiometric assay and agars
Identification of Mycobacterial isolates by DNA probe and GLC

POWERCHART NAME

BLOOD CULTURE FUNGUS

MERCY TEST NAME

BLOOD CLT/FUNGUS

MERCY LAB CODE

BLF

Patients 6 yrs of age and older: 10 ml whole blood drawn into Isolator 10 tube.Short samples decrease the already low number of organisms.

Patients 5 years of age and under: 1.5 ml whole blood drawn into pediatric Isolator tube.

Specimens are to be collected using the following instructions:

1. Disinfect the stopper of isolator tube with 10% pvp iodine.
2. Cleanse and disinfect the venipuncture site, and maintain aseptic technique.
3. Collect blood sample with the patient's arm in a downward position.
   (1.5 ml for patient 5 yrs and under)
   (10 ml for patients over 5 years.)
4. Gently invert the tube 8 to 10 times immediately after collection.Incomplete mixing causes small clots to form.
   Clotted samples are unacceptable and must be redrawn.
5. Transport promptly to the lab.

Preliminary report: 5 days
Final report: 4 weeks

POWERCHART NAME

BODY FLUID CULTURE + SUSCEPTIBILITY + SMEAR DIRECT

MERCY TEST NAME

BODY FLD CLT/GS

MERCY LAB CODE

FLDC

Collect aseptically by needle aspiration or surgical procedure.
Submit all specimens in a sterile syringe with the needle discarded or sterile screw top container or tube. Deliver to the lab as soon as possible.

1. CSF fluid: 1 ml minimum, placed in sterile screw capped tube.Do not refrigerate.
2. Joint: 1 ml aspirate
3. Pericardial: 1 ml aspirate
4. Peritoneal: 1 - 2 ml aspirate
5. Pleural: 5 - 10 ml aspirate
6. Thoracic:5 - 10 ml aspirate

Fluid injected into a CULTURETTTE is unacceptable.
A swab specimen is not adequate.

Send all specimens at room temperature.
CSF specimens MUST NOT be refrigerated.

1. Recovery of microorganisms from these sites is dependent on the volume of specimen received.
2. ALL POSITIVE CSF CULTURES/GRAM STAINS WILL BE PHONED TO PHYSICIAN/NURSING PERSONNEL RESPONSIBLE FOR THE PATIENT.
3. Susceptibility testing will be performed on significant isolates.

Gram stain: Next day 1st shift, unless ordered to be called STAT with a specific phone number indicated.
Preliminary report: 1,2,3,4 days
Final report: 5 days

87205 Gram stain+
87070 Body Fld Clt+

POWERCHART NAME

BORDETELLA PERTUSSIS PCR*

See: Pertussis PCR*

POWERCHART NAME

BRONCHIAL QUALITATIVE + SMEAR DIRECT OTHER

MERCY TEST NAME

BRONCH QAL CLT/GS

MERCY LAB CODE

BQAL

Mark OTHER under Microbiology Cultures on the order form & write Bronchus Culture/Qual.
Write from which bronchus the culture was collected on SOURCE line.

Minimum of 5 ml of bronchus washings collected through the inner chamber of the bronchoscope.Submit in a sterile plastic container with a tight - fitting lid.

1. Only significant respiratory isolates will be reported.
2. Susceptibility testing will be performed on significant isolates.

Gram stain:Next day, 1st shift
Preliminary report: 1 day
Final report: 2 days

87205 Gram stain+
87070 Bronch Clt+

POWERCHART NAME

CULTURE BRONCHIAL QUANTITATIVE + DIRECT SMEAR OTHER

MERCY TEST NAME

BRONCH QNT CLT/GS

MERCY LAB CODE

BQNT

1. Includes quantitation in colony forming units (CFU/ml).
2. Susceptibility testing will be performed on significant isolates.

Gram stain: Next day, 1st shift
Preliminary report: 1 day
Final report: 2 days

87205 Gram Stain+
87070 Bronch Clt+

POWERCHART NAME

CATHETER TIP CULTURE

MERCY TEST NAME

CATHETER TIP CLT

MERCY LAB CODE

CTC

2 inches of catheter tip.

1. Aseptically remove the catheter tip from the patient.
2. Using sterile scissors, cut the catheter 2 inches from the tip.
3. Aseptically place catheter tip in a sterile PLASTIC CONTAINER with a tight-fitting lid.

Foley Tip catheters will not be accepted.
A culturette is not an acceptable transport device.

1. Quantitation will be reported for each isolate.>15 colony forming units (CFU) is considered significant.
2. Susceptibility testing will be performed on significant isolates.

POWERCHART NAME

CHLAMYDIA PROBE

MERCY TEST NAME

CHLAMYDIA SCREEN DNA PROBE

MERCY LAB CODE

CTGP

Urethral or cervical
A ProbeTec ET collection kit (gender specific) is available from the Microbiology Dept.  This kit contains a cleaning swab, collection swab and transport tube for females and a collection swab and transport tube for males. The transporter must be delivered to Mercy Lab within 6 days of collection and should be transported between 2-27 degrees celcius. The same tranporter can be used for GC DNA Probe testing.

Urine
15 – 20 mL of freshly voided urine. The patient should not have urinated for at least 1h prior to specimen collection. Store urine refrigerated @ 2-6°C and deliver the urine to Mercy Lab within 7 days of collection. If the urine was stored @ room temperature before delivery, please call the Mercy Microbiology Department for further instructions (Ext. 7494).

Cervical Specimen Collection:

Use the ProbeTec ET collection kit for females. Using the large cleaning swab provided in the kit, remove the excess mucous from the endocervix.  Discard the swab. Insert the smaller Female Endocervical Swab into the cervical canal and rotate vigorously for approximately 30 seconds.  Avoid touching the vaginal walls when withdrawing the specimen.  Place the swab into the transport tube and snap the swab off at the score mark. Tightly cap the tube and label with the patient’s name, date and time of collection. (Swab must be left in the transport tube.)  Transport at 2-27 degrees celsius, within 6 days of collection.

Urethral Specimen Collection (male):

Use the ProbeTec ET collection kit for males.  Patient should NOT have urinated one hour prior to specimen collection.  Insert a small Dacron swab 2-4 cm into the urethra.  Rotate the swab for 5 seconds and withdraw.  Place the swab in the transport tube and snap the swab off at the score mark. Tightly cap the tube and label with the patient’s name, date and time of collection. (Swab must be left in the transport tube.) Transport at 2-27 degrees celsius, within 6 days of collection.

Urine Collection:

             Collect specimen in a sterile, plastic, preservative-free specimen
             collection cup. The patient should not urinate for at least one
             hour prior to collection of specimen. Patient should collect the
             first 15-20 mL (maximum 60 mL) of a voided urine (the first
             part of stream, not mid-stream). Tightly cap the urine and label
             with the patient’s name, date and time of collection. Store the
             urine in the refrigerator (2-6°C) until transport to Mercy Lab.
             Transport refrigerated, within 7 days of collection.

EYE SPECIMENS ARE NOT APPROVED FOR TESTING WITH THIS METHOD.  SEE: CHLAMYDIA TRACHOMATIS, DIRECT SMEAR  (Eye & Nasopharyngeal)

 

• Transport tubes that are received without collection swabs inside.
• Transport tubes that have expired.
• Transport tubes received with a swab different from the one provided in the collection kit.

• In the case of suspected child abuse, culture is the only recommended procedure. See: Chlamydia Trachomatis Culture
   
  Results are directly dependent on specimen quality.  Inadequate or improperly collected specimens may give false negative results.

TEST NAME

CHLAMYDIA PNEUMONIAE BY PCR

MERCY TEST NAME

CHLAMYDIA PNEUMONIAE BY PCR

MERCY TEST CODE

MISM

TEST NAME

CHLAMYDIA TRACHOMATIS CULTURE

MERCY TEST NAME

CHLAMYDIA TRACHOMATIS CULTURE

MARCY TEST CODE

MISM

Contact Microbiology Department for collection and ordering instructions. Test to be used in suspected child abuse cases.

Sent to Viromed #008565

TEST NAME

CHLAMYDIA TRACHOMATIS DIRECT SMEAR

MERCY TEST NAME

CHLAMYDIA TRACHOMATIS DIRECT SMEAR

MERCY LAB CODE

MISM

Contact Microbiology Department for collection and ordering instructions.

Requires Syva Microtrak slide. Most commonly used for infant conjunctival specimens. Can be used as supplemental testing for verifying the presence of C. Trachomatis on genital specimens. Sent to Mayo. Mayo #8883

TEST NAME

CLOSTRIDIUM DIFFICILE CYTOTOXIN STOOL

MERCY TEST NAME

CLOST DIFF TOXIN

MERCY LAB CODE

CTOX

Patient should be passing 5 or more liquid to soft stools specimens in 24 hours to be tested for Clostridium difficile toxin.  Formed Stools are not indicative of Clostridium difficile associated disease, and will not be tested.  Not to be used for children <2 yrs, as up to 50% of healthy infants are carriers.

This test detects Clostridium difficile toxins A and B but does not distinguish betweenthe two.  Useful as an aid in diagnosis of antibiotic associated pseudomembraneous colitis.

Only submit 1 specimen in a 24 hour period.

Deliver to laboratory as soon as possible, or refrigerate up to 72 hours.

POWERCHART NAME

CRYPTOCOCCAL ANTIGEN SCREEN CSF (MAYO)

MERCY TEST NAME

CRYPTO SCN CSF*

MERCY LAB CODE

CRYPTS

1. Detects the presence of Cryptococcus neoformans in CSF.
2. A concurrent Cryptococcus culture is strongly recommended.

86166-Enzyme Immunoassa (EIA)

28072- Latex Aggluition

POWERCHART NAME

CRYPTOCOCCAL CULTURE + DIREST SMEAR CSF

MERCY TEST NAME

CRYPTO CLT/GS

MERCY LAB CODE

CRYP

Mark OTHER under Microbiology Cultures on the order form & write Cryptococcus CLT/GS.Write CSF on SOURCE line.
Specimen:1 ml CSF minimum.Submit in sterile plastic screw cap tube.

Direct Gram Stain: No yeast seen.

87205 Gram Stain+
87102 Yeast Clt+

TEST NAME

CRYPTOSPORIDIUM

See: Giardia/Cryp Rapid

TEST NAME

CSF CULTURE         

See: Body Fluid Culture/Gram Stain

POWERCHART NAME

CULTURE VIRUS RESPIRATORY

MERCY TEST NAME

RESP VIRUS*

MERCY LAB CODE

VRSRSP

Throat Swabs in a culture transport medium, send refrigerated

Sputum, 0.5 mL, send refrigerated in a screw cap vial.

Tissue, (Lung, Etc.), send refrigerated in a screw cap vial containing 1 - 2 mls sterile saline or multi-microbe medium (M5).

Mumps testing, swab specimens for Mumps must clearly indicate "MUMPS" on request form to insure proper handling and test setup.

Other acceptable sources include Bronchioalveolar Lavage, Bronchial Washings, Tracheal Aspirate or Secretions, and Nasal Swabs/Washings.

***SOURCE IS REQUIRED

Negative

If positive, virus is identified.

87252 Tissue Culture Inoculation

87254 Shell vial (if appropriate)

87176 Homogenization, tissue ( if appropriate)

POWERCHART NAME

CULTURE VIRUS NON-RESPIRATORY

MERCY TEST NAME

NON RESP VIRUS*

MERCY LAB CODE

VRSNR

Body Fluid or Cerebrospinal Fluid (CSF),send 1.0 mL in a screw cap vial.
Ocular or Rectal swabs in culture transport medium.
Stool, 5 - 10g, send refrigerated in a screw cap stool container.
Tissue (Brain, Colon, Kidney, Liver) send refrigerated in a screw cap vial with 1 - 2 mls of sterile saline or multi-microbe media (M5).
Urine (Mumps Only), send 0.5 mL of urine refrigerated in a screw cap vial.

***SOURCE IS REQUIRED

1.  Urine, blood, and bone marrow specimens for CMV are not acceptable for viral culture. See Mayo test #81240 CMV by Rapid PCR

2.  Dermal or lesion specimens are not acceptable for viral culture.  See Mayo #82048 HSV and VZV DNA detection by PCR,Dermal.  (Link to Herpes Zoster)

3.  Genital specimens order HSVPCR for Herpes simplex or Mayo #81241 Varicella Zoster Virus

Negative

If positve, virus is identified.

87252 Tissue Culture Inoculation

87254 Shell vial (if appropriate)

87176 Homogenization, tissue (if appropriate)

TEST NAME

Dermal HSV/VZV by DNA Detection by PCR

See: Herpes Zoster

POWERCHART NAME

DERMATOPHYTE CULTURE

MERCY TEST NAME

DERMATOPHYTE CLT

MERCY LAB CODE

DERMCT

TEST NAME

DIRECT GRAM STAIN

See: Gram Stain Direct

POWERCHART NAME

EAR CULTURE

MERCY TEST NAME

EAR CLT

MERCY LAB CODE

EARC

POWERCHART NAME

ENTEROVIRUS RNA DETECTOR

MERCY TEST NAME

ENTEROVIRUS BY PCR*

MERCY LAB CODE

ENTRPC

1. DO NOT centrifuge specimen.
2. Send specimen refrigerated in a screw-capped, sterile plastic vial.Maintain sterility and forward promptly.

POWERCHART NAME

EYE CULTURE OTHER

MERCY TEST NAME

EYE CLT

MERCY LAB CODE

EYEC

1. Conjunctivitis:
   Touch the involved area with a sterile swab moistened with sterile saline.Ideally, inoculate directly to the appropriate media.However, the swab may be transported in a Culturette.
2. Corneal scrapings:
   The cornea may be anesthetized with 0.5% proparacaine hydrochloride, but better results are obtained if the scrapings are collected without the use of a topical anesthetic.A topical anesthetic may have an antimicrobial effect.Scrape the base and margin of the ulcer.Inoculate these scrapings directly to the appropriate media.

1. The organisms involved in eye infections are often fastidious in nature.
2. Susceptibility testing will be performed on significant isolates.

POWERCHART NAME

FECAL LEUKOCYTES (WBC FECES) SMEAR

MERCY TEST NAME

FECAL LEUKOCYTES

MERCY LAB CODE

FL

1 gm random stool specimen, submit in a clean container with a tight-fitting lid. Deliver to Lab within 1 hour of collection.

If specimen cannot be delivered within 1 hour of collection:

1. Use Parasafe (O&P) vial or Parapak 10% Formalin vial for transport. Add enough stool specimen to bring the liquid level to the fill line in the vial.
2. DO NOT OVERFILL! Mix specimen thoroughly in preservative. Formed specimens must be broken up in the vial.
3. Specimens in preservative must be tested within 5 days of collection.

POWERCHART NAME

CULTURE IDENTIFICATION FUNGUS

MERCY TEST NAME

FUNGAL ID

MERCY LAB CODE

FNID

POWERCHART NAME

FUNGUS CULTURE + DIRECT PREP

MERCY TEST NAME

FUNGUS CLT/DIR PR

MERCY LAB CODE

FUNG

To prevent aerolization, specimens must be submitted in a sterile container with a TIGHT fitting screw top lid.Culturettes must be capped snugly. Submit according to the following guidelines:

1. Body fluid:5 ml minimum.
2. Bone marrow aspirate:0.2 - 0.3 ml in heparinized syringe.
3. Bone marrow biopsy:Transport in a sterile screw-capped container with 1 ml sterile normal saline.
4. Bronchus washings/brushings:5 ml minimum.
5. Corneal scraping or donor cornea:Ophthalmologist is to collect and plate.Contact Microbiology for media.
6. Ear:Swab in Culturette.
7. Hair: Hair and base of shaft in screw-capped container.
8. Nail cuttings
9. Skin scrapings
10. Sputum: 5 ml minimum.
11. Stool: Freshly passed specimen.
12. Tissue: Submit in a sterile plastic container with a tight fitting lid. Add 1‑2 ml of sterile saline,no preservative, to the container to prevent drying of the specimen.
13. Urine: 25-50 ml of clean catch, first morning specimen.
    Catheterized and suprapubic specimens are also acceptable.

Direct preparation: 1 day
Preliminary report: 2,3 weeks
Final report: 4 weeks

Direct exam: No yeast or hyphal elements seen.
Culture: No fungus isolated

87205 Gram Stain+
87102 Fungus Clt+

POWERCHART NAME

GC PROBE

MERCY TEST NAME

NEISSERIA GONORRHEA SCREEN by DNA PROBE

MERCY LAB CODE

GCGP

Urethral or cervical
A ProbeTec ET collection kit (gender specific) is available from the Microbiology Dept.  This kit contains a cleaning swab, collection swab and transport tube for females and a collection swab and transport tube for males. The transporter must be delivered to Mercy Lab within 6 days of collection and should be transported between 2-27 degrees celcius. The same tranporter can be used for Chlamydia DNA Probe testing.

Urine
15 – 20 mL of freshly voided urine. The patient should not have urinated for at least 1h prior to specimen collection. Store urine refrigerated @ 2-6°C and deliver the urine to Mercy Lab within 7 days of collection. If the urine was stored @ room temperature before delivery, please call the Mercy Microbiology Department for further instructions (Ext. 7494).

Cervical Specimen Collection:

Use the ProbeTec ET collection kit for females. Using the large cleaning swab provided in the kit, remove the excess mucous from the endocervix.  Discard the swab. Insert the smaller Female Endocervical Swab into the cervical canal and rotate vigorously for approximately 30 seconds.  Avoid touching the vaginal walls when withdrawing the specimen.  Place the swab into the transport tube and snap the swab off at the score mark. Tightly cap the tube and label with the patient’s name, date and time of collection. (Swab must be left in the transport tube.)  Transport at 2-27 degrees celsius, within 6 days of collection.

Urethral Specimen Collection (Male):

Use the ProbeTec ET collection kit for males.  Patient should NOT have urinated one hour prior to specimen collection.  Insert a small Dacron swab 2-4 cm into the urethra.  Rotate the swab for 5 seconds and withdraw.  Place the swab in the transport tube and snap the swab off at the score mark. Tightly cap the tube and label with the patient’s name, date and time of collection. (Swab must be left in the transport tube.) Transport at 2-27 degrees celsius, within 6 days of collection.

Urine Collection:

             Collect specimen in a sterile, plastic, preservative-free specimen
             collection cup. Patient should collect the first 15-20 mL (maximum 60
             mL) of a voided urine (the first part of stream, not mid-stream).
             Tightly cap the urine and label with the patient’s name, date and time
             of collection. Store the urine in the refrigerator (2-6°C) until transport
             to Mercy Lab. Transport refrigerated, within 7 days of collection.

 

• Transport tubes received without collection swabs inside.
• Transport tubes that have expired. 
• Transport tubes received with a swab different from the one provided in the collection kit.
• Specimen collected from a site other than cervical, male urethral, or urine

• In the case of suspected child abuse, culture is the only recommended procedure.  See: GC Culture.

  Results are directly dependent on specimen quality.  Inadequate or improperly collected specimens may give false negative results.

POWERCHART NAME

GC CULTURE

MERCY TEST NAME

GC SCRN

MERCY LAB CODE

GC

Need special Thayer-Martin Bi-plate agar.

SPECIMEN COLLECTION:

CERVICAL/VAGINAL:

Obtain under direct visualization with a speculum. Lubricants and jellies should be avoided. Speculum may be moistened with warm water. Inoculate onto agar plate according to instructions below.

URETHRAL:

Should not be collected until at least 1 hour after urinating. The external discharge may be used to inoculate the media. If no discharge is present, collect a specimen using a flexible shaft swab.(Calgiswab or Mini‑Tip Culturette).Insert the swab approximately 2 cm into the urethra and gently rotate before withdrawing.Inoculate onto agar plate according to instructions below.

ANAL:

Collect using a swab.Obtain from the crypts just inside anal ring, or by anoscopy to collect mucopurulent exudates directly. Inoculate onto agar plate according to instructions below.

PHARYNGEAL:

Collect using a swab.Obtain from the tonsillar regions and posterior pharynx. Inoculate onto agar plate according to instructions below.

1. Thayer-Martin plates are available from the Microbiology Department.
2. Keep plate refrigerated until needed.       
3. Plate MUST be at room temperature before inoculation.Neisseria gonorrhoeae is very fastidious and will not survive on cold media.
4. One collection site per plate.
5. Inoculate a Thayer‑Martin plate by gently rolling the swab over the agar surface in a zig-zag pattern.Inoculate one specimen source per plate.
6. Label the media side (not lid) of the plate with the patient's first and last name, the site and date of collection.
7. Place the plate in the provided Bio‑Bag. Seal the bag. Crush the CO2 generator. Leave bag in an upright position (zip lock upright) for at least 30 seconds.
8. Keep at room temperature or 35°C. Do not refrigerate or freeze.

Beta lactamase testing is done routinely on isolates of Neisseria gonorrhoeae.

Can be used as supplemental testing for verifying the presence of GC on genital specimen

POWERCHART NAME

GENITAL CULTURE

MERCY TEST NAME

GENITAL LOW CLT

MERCY LAB CODE

GENL

Vulva, Vagina, Cervix, or Urethra.
Collect using a double swab Culturette.

Comments:

1. This culture screens for the presence of Group B Beta Streptococcus, Staphylococcus aureus, Gardnerella vaginalis, and a predominance of yeast.
2. Susceptibility testing will routinely be performed on significant isolates of Staphylococcus aureus.

Gram Stain: 1^st shift
Final report: 2 days

TEST NAME

GIARDIA ASSAY, RAPID

See: Giardia/Cryp Rapid

POWERCHART NAME

GIARDIA+CRYPTOSPORIDIUM ANTIGEN

MERCY TEST NAME

GIARDIA/CRYP RAPID

MERCY LAB CODE

GLCP

87328 Cryptosporidium
87329 Giardia

POWERCHART NAME

GRAM STAIN

MERCY TEST NAME

GRAM STAIN DIRECT

MERCY LAB CODE

GRAM

Specimen:

Any source.
Fluid specimens: Submit in a sterile screw top container.
Other specimens:Submit in a sterile plastic container with a tight‑fitting lid or submit in a double swab Culturette.

TEST NAME

GROUP A STREP SCREEN (THROAT)

See: Strep Screen Group A (Throat)

POWERCHART NAME

GROUP B STREP CULTURE

MERCY TEST NAME

GRP B STREP CLT

MERCY LAB CODE

GBOB

Mark GROUP B STREP CULTURE (OBSTETRICS) on order form. Only 1 order is needed for both specimens. Write collection site(s) on source line.

Both vaginal and rectal specimens are recommended.
Preferred Specimen: Separate culturett from each site, labeled with specimen source.  One double culturette with rectal/vag swab is acceptable.

1. Culture screens for Group B Streptococcus only and is recommended for screening obstetric patients for carrier status.
2. MIC testing is not routinely performed. Please contact the Microbiology lab if patient is at high risk for anaphylaxis due to Penicillin allergy.

TEST NAME

HELICOBACTER SCREEN

MERCY TEST NAME

HELICOBACTER SCN

Gastric mucosal biopsy, 2-3 mm in diameter.
Biopsy should be from normal looking tissue. Patients should not have taken antibiotics or bismuth salts for at least 3 weeks prior to endoscopy/ biopsy.Place specimen in 10% formalin.

POWERCHART NAME

HERPES SIMPLEX PCR

MERCY TEST NAME

HERPES BY PCR*

MERCY LAB CODE

HSVPCR

Monday – Saturday
Results available 3 days from collection.

TEST NAME

HERPES ZOSTER

MERCY TEST NAME

DERMAL, Herpes Simplex Virus & Varicella Zoster Virus, DNA Detection by PCR

MERCY LAB CODE

CMIS

Negative.
If positive HSV1, HSV2, or VZV will be reported.

87529 HSV1 and HSV2
87798 VZV

POWERCHART NAME

INFLUENZA A and B RAPID

MERCY TEST NAME

INFLUENZA A and B, RAPID

MERCY LAB CODE

INFLU

POWERCHART NAME

KOH PREP OTHER

MERCY TEST NAME

KOH PREP

MERCY LAB CODE

KOH

Mark OTHER under Microbiology Cultures on the order form & write KOH Preparation.Write collection site on SOURCE line.
Order "Gram Stain Direct" if the specimen is genital tract and "yeast" is specified.

POWERCHART NAME

CULTURE LEGIONELLA

MERCY TEST NAME

LEGION CULTURE

MERCY LAB CODE

LEGCS

Mark Other under Microbiology cultures on the order form and write Legionella Culture.  Write collection site on the SOURCE line.

Smear DFA: Negative for Legionella species.

Culture:  No Legionella pneumophila isolated.

Smear 87300 x2
Culture 87081 and 87140/identification if needed. 87176 Tissue processing if appropriate.

TEST NAME

MYCOPLASMA CULTURE*

Test No Longer Available

TEST NAME

MYCOPLASMA PNEUMONIAE DNA PCR*

MERCY TEST NAME

MYCOPLASMA PNEUMONIAE DNA PCR*

MERCY LAB CODE

MYCPCR

Bronchalveolar lavage (BAL), bronchial wash, sputum, or respitory spceimen in M4 media.

TEST NAME

NASOPHARYNX CULTURE

See: Respiratory (Upper) Culture/Gram Stain

TEST NAME

NEISSERIA GONORRHOEAE

See: GC Culture/GC DNA Probe

TEST NAME

NOSE CULTURE

See: Respiratory (Upper) Culture/Gram Stain

POWERCHART NAME

OVA AND PARASITE

MERCY TEST NAME

OVA/PARASITES

MERCY LAB CODE

OVA

Mark OVA & PARASITES (under Direct Stool Tests) on order form.
Mark type of specimen: liquid, soft or formed.
This will NOT detect Cryptosporidium.See "Cryptosporidium" if this test is desired.

5-10 gm stool specimen.
Specimen delivered within 1 hour of collection: 5-10 gm of feces submitted in a clean container with a tight-fitting lid.

1. Transfer enough stool specimen to bring liquid level up to the fill line indicated on the Parasafe preservative vial.
   DO NOT OVERFILL! Mix thoroughly. Pieces should be pea size or less.
2. All formed specimens must be broken up in the preservative.
3. Indicate consistency of specimen on vial (liquid, soft, or formed).
4. Specimens in preservative must be tested within 5 days of collection.

1. A concentrate and trichrome stain will be performed.
2. It is recommended that stool specimens be collected and submitted on three consecutive days due to the intermittent nature of some parasites.

87177 Ova & Parasites+
87209 Stain Special+

POWERCHART NAME

PERTUSSIS PCR

MERCY TEST NAME

PERTUSSIS PCR*

MERCY LAB CODE

BPC

Nurse to collect.
Obtain kits from Microbiology.

1. Collect one nasopharyngeal swab from each of the nares of the patient (2 swabs) by passing the sterile thin wire through the nares of the patient until resistance signifies the swab has reached the posterior wall of the pharynx. Rotate axially and hold for 30-60 seconds or until coughing occurs or the patient resists.
2. Place both swabs in the empty tube provided and cut the wires off.  Place the lid on the tube securely.  Write the patient's name, date, and time of collection on the tube that contains the swabs.                                                                                   NOTE:  UHL will accept one swab for testing but the ideal specimen is to have 2 swabs collected and sent.
3. Complete the patient information form and return with the specimens to Mercy Lab.

POWERCHART NAME

PINWORM EXAM

MERCY TEST NAME

PINWORM PREP

MERCY LAB CODE

PIN

Collect